临床荟萃 ›› 2022, Vol. 37 ›› Issue (4): 379-384.doi: 10.3969/j.issn.1004-583X.2022.04.018
• 综述 • 上一篇
廖丁邦1, 陈水文1(
), 李镇清2
收稿日期:2021-12-10
出版日期:2022-04-20
发布日期:2022-05-13
通讯作者:
陈水文
E-mail:csw319@163.com
Received:2021-12-10
Online:2022-04-20
Published:2022-05-13
摘要：
流感嗜血杆菌是引起肺炎、脑膜炎、菌血症、会厌炎、结膜炎、鼻窦炎、蜂窝组织炎等疾病的主要致病菌之一。目前,不可分型流感嗜血杆菌已成为流感嗜血杆菌感染的主要亚型。随着生物膜概念的引入,流感嗜血杆菌致病机制的研究逐渐系统化。本文通过对不可分型流感嗜血杆菌生物膜的形成及其致病机制的研究现状进行综述,旨在为流感嗜血杆菌新型疫苗的研制、抗生素的使用、新型药物的研发提供理论支持。
中图分类号:
廖丁邦, 陈水文, 李镇清. 不可分型流感嗜血杆菌生物膜研究进展[J]. 临床荟萃, 2022, 37(4): 379-384.
| NTHi独立致病因素 | 与人免疫系统的关系 |
|---|---|
| 人补体抑制因子H | 补体激活替代途径的抑制剂,可以与Hi的外膜蛋白结合,减弱补体介导的对NTHi的杀伤作用[ |
| 外膜蛋白P4 | 是NTHi的玻连蛋白结合蛋白,可提高其在血清的存活率,提高了NTHi在人体中的存活率[ |
| HMW和Hia蛋白 | 可以刺激抗体反应,与免疫应答的刺激有关[ |
| IgA1P | 可以掩盖Hi荚膜多糖和其他表面抗原, 有助于逃避宿主的免疫反应。IgA1P的其他底物可以通过避免溶酶体降解来帮助细菌在上皮细胞中存活,可以通过抑制TNF-α的功能来逃避宿主免疫反应诱导的细胞凋亡[ |
| LOS | 具有与人体鞘磷脂结构和抗原性相同的唾液酸末端,可以模拟宿主分子结构逃脱免疫细胞的吞噬和清除[ |
| 唾液酸 | 唾液酸Neu5Ac的掺入除了能提高对血清中抗体的抵抗力,还阻止了半乳糖在庚糖Ⅲ(heptose Ⅲ,Hep Ⅲ)上的识别,从而减少了IgM与细菌表面的结合[ |
| PV | PV中基因oafA 表达是抵抗宿主免疫系统对补体介导的杀伤作用所必需的[ |
| 磷脂酰胆碱 | 在NTHi的LOS中存在的磷脂酰胆碱减少了肺上皮细胞释放IL-1b,从而抑制了炎症的发生,这可能在不触发免疫系统的情况下促进定植[ |
表1 NTHi独立致病因素与人免疫系统的关系
| NTHi独立致病因素 | 与人免疫系统的关系 |
|---|---|
| 人补体抑制因子H | 补体激活替代途径的抑制剂,可以与Hi的外膜蛋白结合,减弱补体介导的对NTHi的杀伤作用[ |
| 外膜蛋白P4 | 是NTHi的玻连蛋白结合蛋白,可提高其在血清的存活率,提高了NTHi在人体中的存活率[ |
| HMW和Hia蛋白 | 可以刺激抗体反应,与免疫应答的刺激有关[ |
| IgA1P | 可以掩盖Hi荚膜多糖和其他表面抗原, 有助于逃避宿主的免疫反应。IgA1P的其他底物可以通过避免溶酶体降解来帮助细菌在上皮细胞中存活,可以通过抑制TNF-α的功能来逃避宿主免疫反应诱导的细胞凋亡[ |
| LOS | 具有与人体鞘磷脂结构和抗原性相同的唾液酸末端,可以模拟宿主分子结构逃脱免疫细胞的吞噬和清除[ |
| 唾液酸 | 唾液酸Neu5Ac的掺入除了能提高对血清中抗体的抵抗力,还阻止了半乳糖在庚糖Ⅲ(heptose Ⅲ,Hep Ⅲ)上的识别,从而减少了IgM与细菌表面的结合[ |
| PV | PV中基因oafA 表达是抵抗宿主免疫系统对补体介导的杀伤作用所必需的[ |
| 磷脂酰胆碱 | 在NTHi的LOS中存在的磷脂酰胆碱减少了肺上皮细胞释放IL-1b,从而抑制了炎症的发生,这可能在不触发免疫系统的情况下促进定植[ |
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